The incidence of the bronchial rupture following blunt chest trauma has increased gradually with the increases of traffic accident and mechanization. We have experienced the 3 cases of the bronchial rupture following blunt chest trauma. The first case was a 38 year old man who was compressed into a blank wall by fork-lift. He complained of severe dyspnea with air leak through the chest tube and right pneumothorax with collapsed lung was seen in his chest X-ray film after closed thoracostomy. Emergency bronchoscopy showed disruptions of the right upper lobar bronchus and the membranous portion of the intermediate bronchus. The second was 8 year old boy who was sustained a crushing chest injury by bus. He also complained of severe dyspnea with air leak through the chest tube and right pneumothorax with collapsed lung was seen in his chest X-ray film after closed thoracostomy. We performed the computed tomogram of the chest and found the bronchial rupture at the distal portion of the right main bronchus. The third case was 40 year old male who was sustained a crushing chest injury by in-car accident. He complained of mild dyspnea without air leak through the chest tube and the left lung was well expanded in his chest X-ray film after closed thoracostomy. Bronchoscopy showed disruption of the 6th cartilaginous portion of the left main bronchus. Emergency bronchoplasties were performed with interrupted end-to-end anastomosis in all cases. Postoperative air leak occurred for 7 days in the third case. Others were uneventful.
Accidents, Traffic ; Adult ; Bronchi ; Bronchoscopy ; Chest Tubes ; Child ; Dyspnea ; Emergencies ; Humans ; Incidence ; Lung ; Male ; Pneumothorax ; Rupture* ; Thoracic Injuries ; Thoracostomy ; Thorax* ; X-Ray Film

No abstract available.

No abstract available.
Echocardiography* ; Humans ; Infant, Newborn*

Using immunohistochemical methods, the authors investigated the distribution of tubulin in normal skin and 31 skin tumors, including 11 benign skin tumors and 20 malignant skin tumors, In normal skin, tubulin was strongly expressed in basal cells of the epidermis, sebaceus celis and dermal nerves. Myoepithelial cells, ductalI cells of sveat ducts and outer root sheath cells of hair follicles stained moderat,ely. Lermal fi broblasts showed no staining. In benign tumors including keratoacanthoma, trichoepithelioma, and nevocellular nevus the strornal fibroblast.s were entirely tubulin negative as well as the turnor cells. In basal cell carcinoma, the stromal fibroblasts were negative',whereas tumor cells were weakly positive. In squarnous cell carcinoma(SCC), tumor cells weri, tubulin positive weakly, the degree of tubulin expression of its stroma1 fibroblasts tencied to be in proportional to the grade of malignanr.u. Tumor cells of malignant melanoma and nevocellular nevus were tubulin positive moderately bist the stromal fibrobla.sts were strongly positive only in the cases of malignant melanoma. These results show that the degree of the tubulin; expression in adjacent, stromal cells of epidermal tumors is in proportiona.l to that of their malignancy, These suggest that the expression of tubulin in fibroblasts surrounding tumor cells of malignant melanoma and SCC reflects a stromal alt,eration that might contribute to tumor in vasion, and play a role for cellular motility.
Carcinoma, Basal Cell ; Epidermis ; Fibroblasts ; Hair Follicle ; Keratoacanthoma ; Melanoma ; Nevus ; Skin* ; Stromal Cells ; Tubulin*

Atypical fibroxanthoma(AFX) occurs most on sun-exposed area of the head and neck of elderly person. It has an excellent prognosis after conservative, but complete, excision. However, because of its potential, albeit small, for metastasis, it is widely regarded as a low-grade sarcoma. We present herein two cases of atypical fibroxanthoma. The case 1 was a 86-year-old female who had a small egg-sized, dome shaped nodule with eroive surface on the left cheek. The other case was a 60-year-old male who had solitry bean-sized, nodulo-ulcerative lesion on the vertex. Immunohistochemical studies revealed positive reaction for vimntin and a-antichymo trypsin. These patients have received completely total surgical ecis on and remained free of recurrence for a period of about, 2 years follow up.
Aged ; Aged, 80 and over ; Cheek ; Female ; Follow-Up Studies ; Head ; Humans ; Male ; Middle Aged ; Neck ; Neoplasm Metastasis ; Prognosis ; Recurrence ; Sarcoma ; Skin* ; Trypsin

Adenosine deaminase(ADA) is an enzyme capable of catalysing the pathway from adenosine to inosine. Previous studies have shown that this enzyme may be useful in recognition of a tubeculous etiology of pleural, peritoneal, or meningeal effusions. ADA activity was studied in 42 patients with large amount of pericardial effusion. Patients were subdivided into the following four group : (A) 15 cases of tuberculous effusions : (B) 4 with pyogenic effusions : (C) 15 with idiopathic effusions : (D) 9 with malignant effusions. The results were as follows ; 1) The mean ADA activities assessed in pericardial effusions were 134.0+/-77.6U/L in group A : 93.8+/-43.8 in group B : 38.3+/-23.2 in group C : 27.3+/-20.8 in group D. Comparing the level achieved in group A with all others, the difference is significant at the P<0.001 level. 2) The mean ADA activities assessed in sera were 50.7+/-57.2 U/L in group A : 63.5+/-24.1 in group B : 25.9+/-12.0 in group C : 14.0+/-7.5 in group D. Comparing the level achieved in group A with all others, there is no significant difference. 3) Specificity(0.87) and sensitivity(0.93) of the test for the differential diagnosis of patients with tuberculous effusion from those with idiopathic effusion is high, when a value of more than 50 U/L is considered. In conclusion, the assessment of ADA in pericardial effusions is of great value in the diagnosis of tuberculous pericarditis.
Adenosine Deaminase* ; Adenosine* ; Diagnosis ; Diagnosis, Differential ; Humans ; Inosine ; Pericardial Effusion* ; Pericarditis, Tuberculous

No abstract available.
Blood Platelets* ; Blood Transfusion*

Dyschromatosis universalis hereditaria was reported in 1933 by Ichikawa and Hiraga in Japan. This disease is characterized by small pigmented and depigmented mottled macules on the trunk and extremities. We report two cases of dyschromatosis universalis. Case one is a 47-year-old man presented with hypoand hyperpigmented spots on the trunk and extrexities. At about 30 years of age, he started to show pigmentary changes on the back, which became progressively spread to the other parts of the trunk and extremities. Case two is a 27-year-old man with numerous mottled hypo-and hyperpigmented spots on the trunk and extremities. He started to show pigmentary changes on the back about 12 years ago. This pigmentary changes also became progressively spread to the other part of the trunk and extrimities. There were no family history of similar disease. On physical exminations, both patients had hrown rice-grain sized pigmented and depigmented macules without scales and atropy on the trunk and extremites. Fontana-Masson stains revealed decreased and increased melar in granules in the basal cell layers in the hypopigrnented and hyperpigmented lesions respectively.
Adult ; Coloring Agents ; Extremities ; Humans ; Japan ; Middle Aged ; Weights and Measures

Papular elastorrhexis is a connective tissue nevus that occurs in the second decade of life as asymptomatic small white-creamy papules scattered over the chest, shoulder, abdomen, or back Histopathologically, there is a decrease in elastic fibers with focal homogenization of collagen. Recognition of this entity is important to prevent use of unnecessary diagnostic procedures and therapy. We present three cases of papular elastorrhexis. All of them occurred in children under the age 10 years.
Abdomen ; Child ; Collagen ; Connective Tissue ; Elastic Tissue ; Humans ; Nevus ; Shoulder ; Thorax

Malignant fibrous histiocytoma is the most common soft tissue sarcoma in adult life and shows a mixed proliferation of both fibroblsstic & histiocytic cells. We report a case of myxoid malignant fibrous histiocytoma involving right lower leg in a 68-year-old male patient, who presented with a childs palm-sized nodular mass of 3 years duration. Histoapthologically, the tumor had varying proportion of myxoid cellular components. The myxoid areas showed spindle and pleomorphic cells arranged in a vague storiform pattern, abrupt transition between a solidly cellular area and a myxoid area, and lipoblast-like cells. The cellular areas showed spindle cells arranged in a storiform pattern characteritic of the typical pleomorphic malignant fibrous histiocytorna.
Adult ; Aged ; Child ; Histiocytoma, Malignant Fibrous* ; Humans ; Leg ; Male ; Sarcoma